NICU - Meet The Team

Babies who are born early need much more energy, protein, vitamins and minerals than babies who are born on their due date so it’s important to make sure they get enough nutrition to grow and develop.

The dietitian’s role is to ensure your baby receives a high standard of nutritional care during and after their stay on the neonatal unit. Those babies born prematurely have unique and sometimes complex nutritional requirements which require specialist knowledge and management. Dietitians will review your baby's nutritional needs, care plans and overall progress. They will attend the nutrition team weekly ward round and always work in partnership with you to ensure that your baby gets all the nutrition they need.

We aim to ensure that babies get the best possible start in life by ensuring early access to breast milk, optimising their nutritional intake and supporting their feeding journey through the neonatal unit and beyond.

All the babies on the neonatal unit are reviewed, however the dietitian tends to be more involved with babies who are: -

• Have feeding difficulties / complications
• Are not growing so well
• Require a special milk
• Have a medical condition which makes feeding and growing more of a challenge

They carefully monitor your baby's nutritional status by:

• Calculating their nutritional requirements for age and gestation and considering factors that will affect this.
• Monitoring their growth (weight, length, and head circumference
• Monitoring blood results
• Reviewing the type of nutrition (intravenous nutrition (TPN), milk or both)
• Reviewing the volume / how much they are receiving and how often.
• Reviewing how they are receiving their nutrition (tube, breast, bottle)
• Checking on their feed tolerance

The dietitian will also help to review and support neonatal babies who have gone home and work closely with our Neonatal Outreach Team, Health Visitors and Speech and Language Therapists to provide on-going support to babies and families who require that little bit of extra help with feeding

I really enjoy being part of our Neonatal Team. It’s a real privilege working with babies and families at such a vulnerable and special time in their lives. Knowing that I can help them get the best start nutritionally fills me with a sense of pride.

- Carol Pinder, Lead Dietician

Learn more: https://www.bliss.org.uk/parents/about-your-baby/feeding

Contact details
Telephone number: 01772 522517
Email: Carol.Pinder@LTHTR.nhs.uk

The role of the Neonatal Physiotherapist is to support the development of babies who may be at risk of having movement or developmental difficulties due to prematurity, problems before / during or after birth, problems affecting joints or muscles or any other problems that may affect baby's movement.

Our Physiotherapist will gather information and assess baby's tone, reflexes, movements and how they tolerate handling and from these assessments decide if a specialist developmental plan / individualised physiotherapy programme may be required and provide support to parents or carers in positioning and handling their baby and ensuring parents are being supported to carry out developmental cares for their baby e.g. skin to skin whilst on the unit. They may also ask for parental consent to take a general movement video which helps form part of their on-going assessment.

Following discharge from the Neonatal Intensive Care Unit, the physiotherapist may refer onto  colleagues in the community if longer term support is required.

The role of the Neonatal Occupational Therapist is to work with the neonatal team and families to promote a neuro-protective developmental care environment for the baby and provide therapeutic interventions to support the baby's sleeping, feeding, daily cares and interactions by:

• Adjusting the environment around the infant to support their neurological and sensory development
• Supporting both infants and parents in the provision of non-pharmacological pain management during painful and stressful caregiving procedures
• Advising on positioning for optimal neurobehavioral regulation
• Promoting sleep protection
• Optimising babies neurobehavioral states during daily cares
• Providing regulatory strategies for positive feeding experiences
• Providing specialist equipment where necessary

When babies are born premature, sick or have complex medical conditions they are at risk of having feeding and early communication difficulties.

The Speech and Language Therapists (SALT) are part of the Neonatal Team and their role is to

• Identify babies who are at risk of feeding difficulties
• Asses these difficulties and create actions plans to manage the difficulties
• Help families understand the skills needed to positively and safely feed their babies
• Promote developmental care, family integrated care and early bonding

The Speech and Language Therapists  play a vital role within the weekly nutritional round ward on the unit to esnure your baby's nutritional needs are being positively met. The team works in close partnership with families to teach and empower you on how to read your baby's behavioural cues ' How your baby is talking to you' enabling a close relationship and bond and ensuring feeding is carried out safely, responsively and positively for baby and family, promoting positive touch, taste and smell.

The team also promote developmental pre-feeding supportive interventions such as:

• Skin To Skin
• Non Nutritive Sucking
• Mouthcare

The Speech and Language Therapists support both breast and bottle feeding and will teach you to recognise your baby's feeding cues, support good positioning and attachment, support the weaning process from tube feeds to responsive breast / bottle feeeding and suggest supportive bottle feeding strategies such as side lying.

Our Speech and Language Therapists  will also assess and manage feeding and swallowing difficulties if they present and will consider and carry out instrumental assessments of swallowing skills onsite and create a structured feeding action plan which will be reviewed regularly. Families will be supported through the discharge process and refer to local services for ongoing support and provide long term follow up.